Image of the hand and torso of an ultrasound technician carrying out an ultrasound scan of a women's stomach to look for uterine fibroids
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Research led by Kaiser Permanente Northern California shows controlling blood pressure in older menstruating women could help prevent the formation of uterine fibroids.

As reported in JAMA Network Open, Susanna Mitro, PhD, a researcher at Kaiser Permanente Northern California, and colleagues found untreated or new hypertension increased new fibroid risk compared with normal blood pressure.

However, treatment of hypertension actually seemed to reduce risk, with this effect being most noticeable in those using blood pressure reducing treatments in the ACE inhibitor class.

“Uterine fibroids are benign, hormonally responsive tumors that occur in 70% to 80% of people with uteruses by age 50 years, approximately one-half of whom have clinically relevant disease,” explain the authors.

“A high-risk time for fibroid diagnosis begins around age 40 years. Although fibroids are common and cause debilitating symptoms, including pain and bleeding, no strategies are available to prevent them.”

There is increasing evidence linking hypertension and other cardiovascular risk factors to fibroid development, but few studies have collected data over time. In this study, Mitro and colleagues used data from the Study of Women’s Health Across the Nation, a prospective, multisite cohort study in the U.S.

Overall, 2570 women without a prior history of fibroids were followed up from enrollment in 1996–1997 until 2013 and had 13 clinic visits during this time. The participants were aged 42–52 years, had at least one menstrual period in the preceding three months and were not pregnant or using hormones.

During the follow-up period, 20 percent of the women reported at least one new fibroid. Some women had hypertension at enrollment (624 women) and others developed high blood pressure during the study.

Those with new onset hypertension were 45 percent more likely to also report a new diagnosis of fibroids compared to women with no hypertension. Untreated, existing hypertension was also associated with a 19% increased risk of fibroids compared with no hypertension.

Women using anti-hypertensive medication had an average reduction in fibroid risk of 37 percent, although this increased to 48 percent if the medication was an ACE inhibitor, compared with no treatment. Treated, hypertensive women also had a 20% reduction in risk for a new fibroid diagnosis compared with women with no hypertension.

“This study of a midlife cohort found that patients with untreated and new-onset hypertension had increased risk of newly reported fibroid diagnosis, whereas those taking antihypertensive medication had a reduced risk,” conclude the researchers.

“Investigation into mechanisms and health implications is warranted; if the associations are causal, antihypertensive medication use where indicated may present an opportunity to prevent clinically apparent fibroid development at this high-risk life stage.”

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